Abstract
BackgroundThe effects of fish oil supplements on lipid profile in dialysis patients are controversial. With increasing interest in the potential health benefits of fish oil, it is important to explore its real effects.ObjectiveWe aimed to identify and quantify the effects of fish oil on triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in dialysis patients.MethodsPubMed, EMBASE and the Cochrane Central Register of Controlled Trials were searched for relevant trials of fish oil and lipid profile in dialysis patients. We identified 209 potential studies and included 13 randomized controlled trials. Eligible studies, determined by consensus using predefined criteria, were reviewed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and a meta-analysis was performed.ResultsCompared with the control group, serum TG and TC levels in the fish oil group were reduced by 0.23 mmol/L (95% CI, −0.31, −0.14, P <0.01) and 0.12 mmol/L (95% CI, −0.23, −0.01, P =0.03), respectively. HDL-C levels were increased by 0.20 mmol/L (95% CI, 0.01, 0.40, P <0.01) attributable to fish oil. In contrast, fish oil did not influence serum LDL-C levels. Subgroup analysis showed the effects of fish oil were stronger in subjects with higher baseline TG levels, and the long-term intervention (>12w) demonstrated a tendency towards greater improvement of serum HDL-C and LDL-C levels compared with short-term intervention (≤12 w). However, both of the changes were not statistically significant in meta-regression analysis. There were no obvious difference in effects of different doses and components of fish oil on lipid levels.ConclusionFish oil supplements reduced serum TG and TC levels, and increased HDL-C levels, without affecting LDL-C levels among dialysis patients. It should benefit patients at risk of cardiovascular diseases. Based on randomized controlled trials, we suggested a daily supplement dose of fish oil for dialysis patients of >1 g, but a high dose might not be necessary.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-511X-13-127) contains supplementary material, which is available to authorized users.
Highlights
Dialysis patients have an inordinate risk of cardiovascular disease (CVD), which remains a major cause of morbidity and mortality in this patient group [1,2]
Our meta-analysis showed supplementation with fish oil was associated with a decrease in TG and total cholesterol (TC), and an increase in high-density lipoprotein cholesterol (HDL-C), but had no significant effects on low-density lipoprotein cholesterol (LDL-C) compared with controls
As a result of dietary restrictions on fish consumption, to control phosphorus intake, dialysis patients have significantly lower levels of omega-3 fatty acids in their erythrocyte membranes [35], and based on randomized controlled trials, we suggest that the daily supplement dose of fish oil for dialysis patients should be >1 g
Summary
Dialysis patients have an inordinate risk of cardiovascular disease (CVD), which remains a major cause of morbidity and mortality in this patient group [1,2]. In the past few years, there has been a growing scientific and public interest in the role of omega-3 fatty acids, mainly obtained from fish and fish oil in CVD, idiopathic IgA nephropathy, lupus nephritis and renal failure. 3 fatty acid supplementation may offer multiple health benefits to dialysis patients [7]. Numerous clinical trials concerning the effects of fish oil supplements on serum lipids in dialysis patients have been published. The results are still inconclusive, because the trials included small numbers of patients and different doses of fish oil, with short duration of observation. We present the results of a systematic review summarizing current evidence from randomized controlled trials of the effects of fish oil supplements on serum lipid profile in dialysis patients. The effects of fish oil supplements on lipid profile in dialysis patients are controversial. With increasing interest in the potential health benefits of fish oil, it is important to explore its real effects
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